The sides of an open incision, as well as matter such as body parts and fluids passing through the incision during surgery, are inherently susceptible to cross-contamination by infectious microorganisms or like matter. Therefore, extreme care is required to insure that any exposed fluids or tissues are completely isolated from each other.
Various designs have been proposed and utilized to prevent transmission of indigenous and exogenous contaminants to healthy viscera from infectious tissues or fluids. U.S. patent application Ser. No. 08/489,044 by Berwyn M. Crook, filed Jun. 9, 1995, now U.S. Pat. No. 5,524,644, describes an incision liner and retractor device which can be installed in an incision, incrementally adjusted in place to form-fit a wide range of cavity wall thicknesses, and retract the sides of the incision apart for better access to the abdominal cavity. It employs a flexible impermeable sleeve with opposite ends terminating at inner and outer resilient O-rings. The inner O-ring is inserted in the cavity by squeezing it through the incision and allowing it to expand around the inner edge of the incision. The outer O-ring is then rolled down over the portion of the liner extending out of the incision until it is tight against the outer rim of the incision and the remaining portion is drawn taut and contiguous with the incision sides. The outer O-ring is generally oblong in cross-section to provide a positive gripping surface for the fingers to roll the outer O-ring more easily, especially when the liner or the surgeon's gloves are slippery.
In many instances, a surgical drape may be first placed over the patient's body before the incision liner and retractor device is installed. This combination further reduces the risk of cross-contamination between the open cavity and the skin around the incision, especially if an organ is brought outside the abdominal cavity to perform surgery on it. However, since the liner and drape are not integrally connected, there is no assurance that the drape may not slide from beneath the outer O-ring and leave the patient's skin exposed in a most vulnerable region immediately adjacent to the incision.
Some prior art surgical protectors address this problem to a limited degree. For instance, U.S. Pat. No. 3,397,692 to Creager, Jr. et al. discloses an incised wound protector in which a resilient ring cemented around the rim of a central aperture in a drape is squeezed together and expanded in the cavity to grip the incised edge of the peritoneum. The drape is bunched together where it passes through the incision and then spreads out over the body surface in radially diminishing wrinkles. U.S. Pat. No. 4,188,945 to Wenander similarly provides a surgical cloth with a semi-rigid thread hemmed in around a central aperture. A portion of the cloth around the aperture is gathered together and inserted in an incision, and then enlarged under the incision edge by increasing the length of thread around the aperture. Like the wound protector of Creager, Jr. et al., a wrinkled surface is created in the incision and around the operating site. Consequently, neither device provides a relatively smooth surface in the incision and around the wound where extracted viscera may be placed nor positive retraction of the sides of the incision. In addition, there is no means for preventing external portions of the drape from slipping in and out of the incision with movement of the surgeon's hand.